Evaluation the effect of the mobile app-based health promotion program for Korean-Chinese middle-aged women using living lab

Background: Cardiovascular disease (CVD) accounts for one-third of the causes of death in women, and migrants are relatively more likely to be exposed to CVD risk owing to social and environmental factors. Objective: This study aimed to examine the effectiveness of a 24-week app-based walking program, using Fitbit, for CVD risk reduction among female Korean-Chinese middle-aged workers. Methods: Participants were recruited between April 11 and July 11, 2018 through distributing posters and flyers. They were randomly assigned to either the standard treatment (ST; n = 22) or enhanced treatment (ET; n = 28) group. All participants were provided with a mobile app linked to Fitbit Alta for 24 weeks and instructed to walk for more than 30 minutes five times a week and moderate intensity physical activity. During the 12-week adaptation period, the ET group also received a mobile app-based health program applying socio-cognitive strategies to increase walking adherence. All participants were guided to voluntary physical activity without researchers' intervention during the 12-week maintenance period. Data were analyzed by the Mann Whitney U-test and a generalized estimating equation. Results: There were significant between-group differences regarding the number of steps (B = 1.295, P < .001).and moderate physical activity time (OR = 6.396, P = .030) at week 12. ET group had significant changes in high-density lipoprotein cholesterol (B = 10.522, P = .007), low-density lipoprotein cholesterol ( B = -16.178, P = .024), total cholesterol (B = -20.325, P = .039), fasting blood sugar (B = -8.138, P = -.046) over 12 weeks compared to the ST group. In addition, there was a significant reduction CVD risk for the ET group over 12 weeks compared to the ST group (B = -0.521, P <. 001). Conclusions: The app-based walking intervention was effective in reducing CVD risk among female Korean-Chinese migrant workers during the 12-week period. In future studies, long-term studies are needed to reduce the risk of cardiovascular disease in large-scale migrant workers, and it is necessary to confirm the direct and indirect effects of various socio-cognitive factors on health outcomes.